If you're over 65, there's a very good reason to take good care of your teeth: It could save your life.
Starting in 1989, health researchers began to find links between gum disease and heart disease. In that year, researchers in Finland established a surprising correlation between dental disease and stroke, heart disease and diabetes.
Even after taking into account age, exercise, diet, smoking, weight, blood cholesterol level, alcohol use and health care, people who had dental disease had a significantly higher incidence of heart disease, stroke and premature death.
Then in 1998 a study of U.S. veterans established a stronger link. It found that dental disease was a larger risk factor for heart disease than being overweight, having a high cholesterol level, not exercising or smoking.
How can this be? Well, we might not like to think about it, but our mouths are full of bacteria. Diseased gums are prone to easily bleed, through brushing or even chewing food. Where there's blood, there's an entry way for bacteria into the blood stream.
In a recent study of 290 dental patients, researchers investigated several measures of bacteremia, the process by which bacteria released into the bloodstream, during three different dental activities — tooth brushing, a single tooth extraction with a preventive antibiotic and a single tooth extraction with a placebo.
As expected, researchers found bacteria in the blood more often with the two extraction groups than with the brushing group. However, the incidence of bacteremia from brushing was closer to an extraction than expected.
"This suggests that bacteria get into the bloodstream hundreds of times a year, not only from tooth brushing, but also from other routine daily activities like chewing food," said the study's lead author Peter Lockhart, D.D.S.
In 2007, the American Heart Association modified its recommendation that preventive antibiotics be used prior to most dental procedures for the great majority of those at risk for infective endocarditis (IE) — a rare but life-threatening infection of the lining of the heart or heart valve that can occur when bacteria enter the bloodstream. The association now recommends preventive antibiotics only for patients at the highest risk for a bad outcome from IE.
The lesson, health experts say, is to maintain good dental hygiene as you age. Daily brushing and flossing not only removes food deposits, but helps keep teeth and gums healthy, making gums less likely to bleed.
"If you stop oral hygiene measures, the amount of disease in your mouth goes up considerably and progressively and you'll have far worse oral disease," Lockhart said. "It's the gum disease and dental decay that lead to chronic and acute infections such as abscesses. It's that sort of thing that puts you at risk for frequent bacteremia and presumably endocarditis if you have a heart or other medical condition that puts you at risk."
